Comparison of Caudal Block Versus Penile Nerve Block in Terms of Post Operative Pain in Children Undergoing Penile Procedures

Background: One of key outcome of every surgical procedure is to keep patient pain free. It is of great importance to keep pediatric age group pain free post operatively. Various nerve block techniques are in use to provide pain relief during and early postoperative period. The most common regional block techniques used for perineal surgery are penile block, inguinal block and caudal block. Study Design: Randomized controlled trial. Place and Duration: From March 2012 to Sept 2012, Pakistan Institute of Medical Sciences, Islamabad Materials Methods: This Randomized Clinical Trial included 136 male patients between ages of 15 days to 12 years. Patients were randomly equally divided into two groups PENILE BLOCK group and CAUDAL BLOCK group. Face, Legs, Activity, Cry, Consolability (FLACC) pain scale was used for the measurement of postoperative pain. Results: The mean age of patients was 3.2 + 2.4 years in group A (penile block) and 3.9 + 2.8 years in group B (caudal block). In group A, 46 (67.6%) cases had hypospadias repair compared to 43 (63.2%) in group B. Similarly, in group A, 15 (22.1%) underwent circumcision and in group B, 13 (19.1%) had this procedure. The total duration of anaesthesia was shorter in penile group (102.1 + 15.4 min) compared to caudal block group (113.4 + 11.8 min). The mean pain score was found out statistically different and less pain was experienced by penile group compared with caudal block anesthesia (pvalue = 0.001) Conclusion: We conclude that single dose penile block is superior to caudal epidural block for the relief of postoperative pain in children undergoing different penile surgeries.